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Organization

FORT WORTH VASCULAR SPECIALISTS CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YURY GAMPEL (MANAGER)
(818) 880-8605
Entity
Organization

Contact information

Practice address
5750 STRATUM DR, FORT WORTH, TX 76137-2757
(817) 989-2580
(817) 989-6555
Mailing address
26500 AGOURA RD STE 102-587, CALABASAS, CA 91302-1952
(818) 880-8605
(818) 579-7916

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2471V0106X
Vascular-Interventional Technology Radiologic Technologist

Other

Enumeration date
03/10/2020
Last updated
06/05/2020
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